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Abstract Background To explore the pulmonary-vascular-stump filling-defect on CT and investigate its association with cancer progression. Methods Records in our institutional database from 2018 to 2022 were retrospectively analyzed to identify filling-defects in the pulmonary-vascular-stump after lung cancer resection and collect imaging and clinical data of patients. Results Among the 1714 patients analyzed, 95 cases of filling-defects in the vascular stump after lung cancer resection were identified. After excluding lost-to-follow-up cases, a total of 77 cases were included in the final study. Morphologically, the filling-defects were dichotomized as 46 convex-shape and 31 concave-shape cases. Concave defects exhibited a higher incidence of increase compared to convex defects (51.7% v. 9.4%, P = 0.001). Among 61 filling defects in the pulmonary arterial stump, four (6.5%) increasing concave defects showed the nuclide concentration on PET and extravascular extension. The progression-free survival (PFS) time differed significantly among the concave, convex, and non-filling-defect groups (log-rank P

Abstract Efficient charge-carrier injection and transport in organic light-emitting devices (OLEDs) are essential to simultaneously achieving their high efficiency and long-term stability. However, the charge-transporting layers (CTLs) deposited by various vapor or solution processes are usually in amorphous forms, and their low charge-carrier mobilities, defect-induced high trap densities and inhomogeneous thickness with rough surface morphologies have been obstacles towards high-performance devices. Here, organic single-crystalline (SC) films were employed as the hole-transporting layers (HTLs) instead of the conventional amorphous films to fabricate highly efficient and stable OLEDs. The high-mobility and ultrasmooth morphology of the SC-HTLs facilitate superior interfacial characteristics of both HTL/electrode and HTL/emissive layer interfaces, resulting in a high Haacke’s figure of merit (FoM) of the ultrathin top electrode and low series-resistance joule-heat loss ratio of the SC-OLEDs. Moreover, the thick and compact SC-HTL can function as a barrier layer against moisture and oxygen permeation. As a result, the SC-OLEDs show much improved efficiency and stability compared to the OLEDs based on amorphous or polycrystalline HTLs, suggesting a new strategy to developing advanced OLEDs with high efficiency and high stability.

Abstract As the boost of power electronics technology, the harmonic problem in the power system is becoming increasingly prominent. Fourier decomposition is performed on the load current in the power system, and components with a frequency that is an integer multiple of the fundamental wave are referred to as harmonic components. Harmonic control is essential to establish a safe and reliable power grid environment and provide high-quality and clean electricity to power users. The study focused on parallel active power filters, proposed a specific harmonic detection method on the grounds of synchronous harmonic rotating coordinate system, and developed a phase-locked loop design on the grounds of order generalized integrator. Meanwhile, a compensation current control method on the grounds of space vector pulse width modulation was introduced. The results showed that in the full compensation simulation experiment, the compensated A-phase grid side current waveform was significantly improved and presented a sinusoidal shape. After 0.05 s, the actual output compensation current closely followed the command current. Meanwhile, after compensation, the total harmonic distortion rate decreased from 26.58 to 3.06%. In specific harmonic compensation simulation experiments, when the sum of 5th, 7th, and 11th harmonic components was used as the command current for compensation, the distortion of the current waveform was improved after the load undergoes a sudden change. After compensation, the 5th, 7th, and 11th harmonic content significantly decreased, and the total harmonic distortion rate decreased to 4.08%. This indicated that the proposed phase-locked loop design and harmonic detection method for active power filters had high stability and effectiveness. The study’s primary contribution is to enhance the utilization efficiency of DC voltage and improve the dynamic response ability of current. Additionally, it offers a new method for reducing the impact of harmonics on the power grid and improving power quality. It provided an effective method reference for technological progress in related fields such as power electronics and control engineering.

Immune checkpoint inhibitors (ICIs) including anti-programmed death cell protein 1 (anti-PD1) and anti-programmed cell death-ligand 1 (PD-L1), by disinhibiting the antitumor responses of lymphocytes, have extended survival benefits for patients in lung cancer. ICIs can also lead to a wide spectrum of immune-related adverse events (irAEs), due to dysregulation of immune reactions. Here, we report a 27-year-old female patient with adenocarcinoma of the lung treated with pembrolizumab-combined chemotherapy treatment, who complained of urinary irritation symptoms. No bacteria were found in multiple urine cultures. B-mode ultrasonography indicated a high echo in the right lateral wall of the bladder, about 5.6 × 4.5 mm in size. Transurethral bladder tumor resection (TURBT) was operated. At biopsy, we found CD3+ CD8+ lymphocyte, plasma cell, and eosinophil infiltration and lymphoid follicle formation in the bladder mucosal layer. This is a report of non-bacterial inflammation of the urinary tract caused by immunotherapy.

In the domain of gas pipeline operations, significant safety hazards prevail. This study delves into the triggering mechanisms behind gas pipeline leakage incidents, pinpoints key risk factors contributing to these occurrences, and proposes effective control measures. By classifying risk coupling forms associated with various accidents, the N-K model formula is utilized to assess the coupling degree of primary risk factors. The resultant coupling relationship is integrated into the University of California at Irvine NETwork (UCINET), forming a complex network model for quantitative analysis. Secondary risk factors' coupling degrees are measured, and the network's characteristic parameters are scrutinized. Noteworthy risk factors within the network include improper maintenance (A3), unclear or missing signage (C4), equipment aging and wear (B10), unauthorized occupation of ground space (C5), failure to implement rules and regulations (D3), and failure of electrical protection (B5). By controlling the above risk factors, disrupting the coupling process of risk factors, and blocking the transmission pathways of risk factors, the objective is to prevent leakage incidents and ensure the safe operation of gas pipelines.

Magnetic reconnection plays a crucial role in the energy release process for different kinds of solar eruptions and activities. The rapid solar eruption requires a fast reconnection model. Plasmoid instability in the reconnecting current sheets is one of the most acceptable fast reconnection mechanisms for explaining the explosive events in the magnetohydrodynamics (MHD) scale, which is also a potential bridge between the macroscopic MHD reconnection process and microscale dissipations. Plenty of high-resolution observations indicate that the plasmoid-like structures exist in the high-temperature solar corona, but such evidences are very rare in the lower solar atmosphere with partially ionized plasmas. Utilizing joint observations from the Goode Solar Telescope and the Solar Dynamics Observatory, we discovered a small-scale eruptive phenomenon in NOAA Active Region 13085, characterized by clear reconnection cusp structures, supported by nonlinear force-free field extrapolation results. The plasmoid-like structures with a size of about 150 km were observed to be ejected downward from the current sheet at a maximum velocity of 24 km s ^−1 in the H α line wing images, followed by enhanced emissions at around the postflare loop region in multiple wavelengths. Our 2.5D high-resolution MHD simulations further reproduced such a phenomenon and revealed reconnection fine structures. These results provide comprehensive evidences for the plasmoid-mediated reconnection in partially ionized plasmas, and suggest a unified reconnection model for solar flares with different length scales from the lower chromosphere to the corona.

The use of existing natural gas pipelines for the transport of hydrogen/natural gas mixtures can achieve large-scale, long-distance and low-cost hydrogen transportation. A jet fire induced by the leakage of high-pressure pure hydrogen and hydrogen-blended natural gas pipelines may pose a severe threat to life and property. Based on the Abel–Nobel equation of state and a notional nozzle model, an equivalent pipe leakage model is established to simulate high-pressure pipeline gas leakage jet fire accidents. Large-scale high-pressure hydrogen and natural gas/hydrogen mixture jet fires are simulated, showing the jet impingement process and obtaining an accurate and effective simulation framework. This framework is validated by comparing the simulated and experimental measured results of flame height, flame appearance and thermal radiation. Several combustion models are compared, and the simulated data show that the non-premixed chemical equilibrium combustion model is superior to other combustion models. The influence of the pipe pressure and the hydrogen blending ratio on the consequences of natural gas/hydrogen mixture pipeline leakage jet fire accidents is explored. It is found that when the hydrogen blending ratio is lower than 22%, the increase in the hydrogen blending ratio has little effect on the decrease in the thermal radiation hazard distance.

Abstract Purpose Small cell lung cancer (SCLC) is an aggressive and rapidly progressive malignant tumor characterized by a poor prognosis. Chemotherapy remains the primary treatment in clinical practice; however, reliable biomarkers for predicting chemotherapy outcomes are scarce. Methods In this study, 78 SCLC patients were stratified into “good” or “poor” prognosis cohorts based on their overall survival (OS) following surgery and chemotherapeutic treatment. Next-generation sequencing was employed to analyze the mutation status of 315 tumorigenesis-associated genes in tumor tissues obtained from the patients. The random forest (RF) method, validated by the support vector machine (SVM), was utilized to identify single nucleotide mutations (SNVs) with predictive power. To verify the prognosis effect of SNVs, samples from the cbioportal database were utilized. Results The SVM and RF methods confirmed that 20 genes positively contributed to prognosis prediction, displaying an area under the validation curve with a value of 0.89. In the corresponding OS analysis, all patients with SDH, STAT3 and PDCD1LG2 mutations were in the poor prognosis cohort (15/15, 100%). Analysis of public databases further confirms that SDH mutations are significantly associated with worse OS. Conclusion Our results provide a potential stratification of chemotherapy prognosis in SCLC patients, and have certain guiding significance for subsequent precise targeted therapy.

In the green synthesis reaction of adipic acid, the oxidant H2O2 undergoes exothermic decomposition easily and the high exothermic amount of the reaction can easily lead to thermal runaway. This study carries out calorimetric experiments on the green synthesis reaction of adipic acid, studies the effect of the stabilizer ethylenediaminetetraacetic acid (EDTA) on the safety of the synthesis reaction, and further explores the effect of EDTA on the Na2WO4-catalyzed decomposition reaction of H2O2 under the conditions of continuous flow, and develops the microchannel continuous flow process of green synthesis of adipic acid containing EDTA, in order to provide theoretical support for the improvement of intrinsic safety of green synthesis of adipic acid.

Plasmoid instability usually accounts for the onset of fast reconnection events observed in astrophysical plasmas. However, the measured reconnection rate from observations can be one order of magnitude higher than that derived from magnetohydrodynamic (MHD) simulations. In this study, we present the results of magnetic reconnection in the partially ionized low solar atmosphere based on 2.5D MHD simulations. The whole reconnection process covers two different fast reconnection phases. In the first phase, the slow Sweet–Parker reconnection transits to the plasmoid-mediated reconnection, and the reconnection rate reaches about 0.02. In the second phase, a faster explosive reconnection appears, with the reconnection rate reaching above 0.06. At the same time, a sharp decrease in plasma temperature and density at the principle X-point is observed, which is associated with the strong radiative cooling, the ejection of hot plasma from the local reconnection region, or the motion of the principle X-point from a hot and dense region to a cool and less dense region along the narrow current sheet. This causes gas pressure depletion and increases magnetic diffusion at the main X-point, resulting in the local Petschek-like reconnection and a violent and rapid increase in the reconnection rate. This study for the first time reveals a common phenomenon where the plasmoid-dominated reconnection transits to an explosive faster reconnection with a rate approaching the order of 0.1 in partially ionized plasma in the MHD scale.

In order to solve the problems of grain lifter in sorghum harvesting, such as ear loss and serious crop leakage loss, combined with the physical and mechanical characteristics of sorghum, the segmented and reverse spiral grain lifter for sorghum harvesting and cutting table was developed, and the design method of the main structural parameters of the grain lifter was determined. The comparative test of the working effect of the clasp showed that the working effect of the cutting table with the clasp was better than that without the clasp, which effectively reduced the harvest loss of the cutting table. By using Box–Behnken experimental design method, the influence law of forward speed, tilt angle, and rotation speed of grain lifter on the rate of ear loss and harvest loss in sorghum harvesting was investigated. The regression mathematical model and response surface of the rate of ear loss and harvest loss and analysis factors were established, and the optimal working parameters of the grain lifter were determined. The forward speed was 0.8 m/s, the tilt angle of the grain lifter was 28°, and the rotation speed of the grain lifter was 330 r/min. Under these conditions, the spike loss rate was 2.01, the leakage loss rate was 2.19, and the error with the theoretical value was less than 3%, which proved the rationality of the optimized combination parameters. In the harvest of crooked and fallen sorghum, the grain lifter can effectively reduce the loss of sorghum head drop and lodging leakage, ensure the reliability of the cutting table, and achieve low loss and efficient harvest of sorghum.

The present study investigates the diffusion bonding of leaded-tin bronze (CuSn10Pb10) and 45 steel via surface modification method, i.e., hot-dip tin coating (HDTC) treatment, so as to provide guidance for the application of copper/steel joints. The effect of HDTC treatment on the interfacial microstructure and mechanical performance of CuSn10Pb10/45 steel joint is established. The results show that the interfacial crack is formed during diffusion bonding of CuSn10Pb10 and 45 steel without HDTC treatment. However, HDTC treatment evidently promotes the mutual diffusion of elements between CuSn10Pb10 and 45 steel, and a metallurgical CuSn10Pb10/HDTC 45 steel joint with a transition layer consisting of Fe-enriched solid solution, Cu-enriched solid solution and Cu10Sn3 intermetallic compound is obtained. The CuSn10Pb10/HDTC 45 steel joint at a bonding temperature of 900 °C shows higher shear strength and better ductility than that of CuSn10Pb10/45 steel joint. With the increasing of bonding temperature, the promoted occurrence and aggregation of Cu10Sn3 intermetallic compound in the CuSn10Pb10/HDTC 45 steel bonding interface results in the increase in shear strength, but the decrease in ductility of joint.

ABSTRACT Transcriptional factors (TFs) and their regulons make up the gene regulatory networks. Here, we developed a method based on TF-directed activation-induced cytidine deaminase (AID) mutagenesis in combination with genome sequencing, called AIDmut-Seq, to detect TF targets on the genome. AIDmut-Seq involves only three simple steps, including the expression of the AID-TF fusion protein, whole-genome sequencing, and single nucleotide polymorphism (SNP) profiling, making it easy for junior and interdisciplinary researchers to use. Using AIDmut-Seq for the major quorum sensing regulator LasR in Pseudomonas aeruginosa, we confirmed that a few TF-guided C-T (or G-A) conversions occurred near their binding boxes on the genome, and a number of previously characterized and uncharacterized LasR-binding sites were detected. Further verification of AIDmut-Seq using various transcriptional regulators demonstrated its high efficiency for most transcriptional activators (FleQ, ErdR, GacA, ExsA). We confirmed the binding of LasR, FleQ, and ErdR to 100%, 50%, and 86% of their newly identified promoters by using in vitro protein-DNA binding assay. And real-time RT-PCR data validated the intracellular activity of these TFs to regulate the transcription of those newly found target promoters. However, AIDmut-Seq exhibited low efficiency for some small transcriptional repressors such as RsaL and AmrZ, with possible reasons involving fusion-induced TF dysfunction as well as low transcription rates of target promoters. Although there are false-positive and false-negative results in the AIDmut-Seq data, preliminary results have demonstrated the value of AIDmut-Seq to act as a complementary tool for existing methods. IMPORTANCE Protein-DNA interactions (PDI) play a central role in gene regulatory networks (GRNs). However, current techniques for studying genome-wide PDI usually involve complex experimental procedures, which prevent their broad use by scientific researchers. In this study, we provide a in vivo method called AIDmut-Seq. AIDmut-Seq involves only three simple steps that are easy to operate for researchers with basic skills in molecular biology. The efficiency of AIDmut-Seq was tested and confirmed using multiple transcription factors in Pseudomonas aeruginosa. Although there are still some defects regarding false-positive and false-negative results, AIDmut-Seq will be a good choice in the early stage of PDI study.

Thermal decomposition experiment of 5-(4-Pyridyl)tetrazolate (H4-PTZ) was carried out. The heat flow curve and reaction rate data under different heating rates were obtained. The characteristic parameters were obtained. The apparent activation energy for each individual reaction was calculated by applying different methods. On this basis, the Malek method was used to predict the most probable mechanism function of thermal decomposition reaction of H4-PTZ. The thermal safety parameters, including self-accelerating decomposition temperature, hot spot fire temperature and thermal explosion critical temperature were also predicted. The activation enthalpy, activation entropy, and activation Gibbs free energy of H4-PTZ are calculated. Gaussian16 program was used to optimize the molecular structure, search the transition state and calculate the intrinsic reaction coordinates of H4-PTZ. The most probable decomposition path of H4-PTZ was found, and the activation energy calculated by experiment was compared with that calculated by the theory.

Objective To describe a non‐anatomical arthroscopic all‐inside repair of medial meniscus posterior root tear (MMPRT) to posterior cruciate ligament (PCL) technique for patients with normal lower limb alignment and to evaluate the short‐term clinical and radiologic outcomes. Methods MMPRT directly to PCL was repaired with all‐inside horizontal mattress suturing technique rather than by the transtibial pullout suture technique or anchor suturing repair technique in 20 Laparade Type II MMPRT patients with normal lower limb alignment during 2018–2019. The clinical and radiological outcomes were evaluated retrospectively for at least 2 years follow‐up. The VAS score, Lysholm score, Tegner activity score were evaluated preoperatively and at the final follow‐up. The status of the medial meniscus posterior root were assessed on magnetic resonance imaging (MRI) preoperatively and at the final follow‐up. Results Twenty patients (mean age 54.5 ± 19.5 years) were included in the present study. The mean follow‐up duration was 32.5 ± 5.8 months. The VAS score was significantly decreased from preoperative 6.5 ± 1.5 to 2.1 ± 1.4 at the final follow‐up (P

Cell envelope proteases (CEPs) can break down milk protein into peptides with different functions, which are of great benefit to human health. Therefore, the high-yield CEPs of Lactobacillus plantarum have the potential to produce functional dairy products. In previous experiments, we found that Na2HPO4, inulin, casein peptone and leucine have significant effects on CEP production by Lactobacillus plantarum LP69. So we proceeded to optimize the composition of the CEP-producing culture medium of L. plantarum through Box-Behnken design and response surface methodology. The protease activity, protein content and specific activity of CEPs produced by L. plantarum by inulin (0.2, 0.3, 0.4 %), casein peptone (0.4, 0.6, 0.8 %), Na2HPO4 (0.50, 0.52, 0.54 %) and leucine (14, 16, 18 mg/L) were evaluated. The optimal ratio of medium is 0.4 % inulin, 0.66 % casein peptone, 0.5 % Na2HPO4 and 14.04 mg/L Leucine. The final enzyme activity reached (24.46±0.81) U/mL, and the specific activity reached (1.41±0.46) U/mg.

ABSTRACT The part of expression noise that is brought about by transcriptional regulation (represented here as NTR) is an important criterion for estimating the regulatory mode of a gene. However, characterization of NTR is an under-explored area, and there is little knowledge regarding the genome-wide NTR in the model pathogen Pseudomonas aeruginosa. Here, with a library of dual-color transcriptional reporters, we estimated the NTR for over 90% of the promoters in P. aeruginosa. Most promoters exhibit low NTR, while 42 and 115 promoters with high NTR were screened out in the exponential and the stationary growth phases, respectively. Specifically, a rearrangement of NTR was found in promoters involved in amino acid metabolism when bacteria enter the exponential phase. In addition, during the stationary phase, high NTR was found in a wide range of iron-related promoters involving siderophore synthesis and heme uptake, ExsA-regulated promoters involving bacterial virulence, and FleQ-regulated promoters involving biofilm development. We also found a large-scale negative dependence of transcriptional regulation between high-NTR promoters belonging to different functional categories. Our findings offer a global view of transcriptional heterogeneity in P. aeruginosa. IMPORTANCE The phenotypic diversity of Pseudomonas aeruginosa is frequently observed in research, suggesting that bacteria adopt strategies such as bet-hedging to survive ever-changing environments. Gene expression noise (GEN) is the major source of phenotypic diversity. Large GEN from transcriptional regulation (represented as NTR) represent an evolutionary necessity to maintain the copy number diversity of certain proteins in the population. Here, we provide a system-wide view of NTR in P. aeruginosa under nutrient-rich and stressed conditions. High NTR was found in genes involved in flagella biosynthesis and amino acid metabolism under both conditions. Specially, iron acquisition genes exhibited high NTR in the stressed condition, suggesting a great diversity of iron physiology in P. aeruginosa. We further revealed a global negative dependence of transcriptional regulation between those high-NTR genes under the stressed condition, suggesting a mutually exclusive relationship between different bacterial survival strategies.

Compared with traditional volume space-based multivariate pattern analysis (MVPA), surface space-based MVPA has many advantages and has received increasing attention. However, surface space-based MVPA requires considerable programming and is therefore difficult for people without a programming foundation. To address this, we developed a MATLAB toolbox based on a graphical interactive interface (GUI) called surface space-based multivariate pattern analysis (SF-MVPA) in this manuscript. Unlike the traditional MVPA toolboxes, which often only include MVPA calculation processes after data preprocessing, SF-MVPA covers the complete pipeline of surface space-based MVPA, including raw data format conversion, surface reconstruction, functional magnetic resonance (fMRI) data preprocessing, comparative analysis, surface space-based MVPA, leave one-run out cross validation, and family-wise error correction. With SF-MVPA, users can complete the complete pipeline of surface space-based MVPA without programming. In addition, SF-MVPA is designed for parallel computing and hence has high computational efficiency. After introducing SF-MVPA, we analyzed a sample dataset of tonal working memory load. By comparison with another surface space-based MVPA toolbox named CoSMoMVPA, we found that the two toolboxes obtained consistent results. We hope that through this toolbox, users can more easily implement surface space-based MVPA.

This study focuses on a novel humidity sensor composed of graphene-oxide (GO)-supported MoTe2 nanosheets. Conductive Ag electrodes were formed on PET substrates by inkjet printing. A thin film of GO-MoTe2 was deposited on the Ag electrode used for adsorbing humidity. The experiment’s results demonstrate that MoTe2 are attached to GO nanosheets uniformly and tightly. The capacitive output of the sensors with various ratios of GO/MoTe2 has been tested for different levels of humidity (11.3–97.3%RH) at room temperature (25 °C). As a consequence, the obtained hybrid film exhibits superior sensitivity (94.12 pF/%RH). The structural integrity and interaction of different components were discussed to afford the prominent humidity sensitivity performance. Under the bending condition, the output curve of the sensor has no obvious fluctuation. This work provides a low-cost way to build flexible humidity sensors with high-performance in environmental monitoring and healthcare.

Cell-envelope proteinases (CEPs) can hydrolyze casein into functional peptides, which is beneficial to the health of the host. The single factor experiment screened out that the optimal conditions for CEP production by Lactobacillus plantarum LP69 were 37°C, 20h, initial pH of 7, and optimal inoculation amount of 5%. The best conditions for this experiment were obtained by orthogonal experiment: time 22h, temperature 39°C, initial pH value of 6, and inoculation amount of 5%. Under this culture condition, the target protease activity of Lactobacillus plantarum LP69 reached 22.31±0.82U/mL, the protein content was 19.07±0.36mg/mL, and the specific activity was 1.17±0.06U/mg. The specific activity significantly increased by 15.8% compared with the control (p

Abstract Objectives The purpose of the present paper was to study isolated meniscal ramp lesions without obvious ACL rupture. Their biomechanical mechanisms were analyzed and their clinical characteristics were reviewed. The clinical effects of an all‐inside horizontal mattress suture for isolated ramp lesions were evaluated. Materials and Methods Twenty isolated meniscal ramp lesion patients without obvious ACL rupture from 2015 to 2017 were retrospectively reviewed. Preoperative MRI showed intact ACL and signs of ramp lesions. These isolated ramp lesions were arthroscopically confirmed and repaired through an all‐inside horizontal mattress suturing method. MRI was performed 3 months postoperatively to assess isolated ramp lesion healing. The Tegner–Lysholm score and the visual analog scale score were recorded preoperatively and at 2 years postoperatively. The Wilcoxon rank sum test was performed to determine statistical significance. Results Arthroscopic exploration confirmed isolated ramp lesions and longitudinal ACL splits or degeneration without obvious ACL rupture. MRI 3 months postoperatively showed healing of the isolated ramp lesions. At 2 years postoperatively, the VAS scores were significantly decreased and the Tegner–Lysholm scores were significantly increased. Knee function, without pain, was restored in all patients, including walking, climing and descending stairs, and squatting. Conclusion Isolated meniscal ramp lesions without obvious ACL rupture may exist because of ACL longitudinal splits or degeneration and can be repaired through anterolateral and anteromedial portals with an all‐inside horizontal‐mattress suturing method.

IntroductionImmunosuppressed patients with bloodstream infection are at risk of mortality. Our objective was to assess the independent risk factors of bloodstream infection with mortality in immunosuppressive states.MethodsThe medical data of a total of 896 patients who were hospitalized in our hospital were collected from January 2015 to December 2019. Evaluation of the independent risk factors of mortality was done by univariate and multivariate logistic regression analyses.ResultsOf the 896 immunosuppressed patients with bloodstream infection, 698 had over 60-day survivals and 198 had 60-day mortality. In our study, PCT (mean ±; standard: 11.40 ±; 31.89 µg/l vs. 62.45 ±; 17.10 µg/l, p = 0.007) and presence of age >60 years (40% vs. 14.19%, p = 0.001) were significantly different between situations with and without 60-day survivals in both univariate and multivariate logistic regression analyses. Age >60 years and PCT could be used as indicators for bloodstream infection with 60-day death in immunosuppressive states; the OR (95% CI) were 1.532 (1.099–2.135) and 2.063 (1.413–3.013), respectively. In different subgroups, PCT and age were also independent risk factors of blood system diseases, Klebsiella pneumoniae infection, diabetes, and ICU-stay subgroups.ConclusionsAge and PCT were independently associated with mortality in immunosuppressive states, which may help to identify the highly risky situation of bloodstream infection in immunosuppressive states.

Abstract Background To investigate the feasibility, safety and therapeutic efficacy of arthroscopy in managing the 3 most common soft tissue complications, peripatellar impingement (PI), arthrofibrosis (AF) and generalized synovitis (GS), after total knee arthroplasty (TKA). Methods A retrospective review of patients undertaking arthroscopy for PI, AF and GS was conducted. Outcome measures included complications, postoperative range of motion (ROM), Knee Society Score (KSS) and rates of symptom recurrence, prosthesis revision. Intraoperative findings and surgical procedures were also recorded. Paired t test, Fisher’s exact test, Kruskal-Wallis test and post hoc analysis with Bonferroni correction were used for statistical evaluation. Results A total of 74 patients, including 35 patients with peripatellar impingement, 25 patients with arthrofibrosis and 14 patients with generalized synovitis, with a mean age of 66.1 ± 7.9 years, were analysed. The mean follow-up (FU) duration was 81.3 ± 40.6 months. All patients underwent arthroscopic surgery safely without intraoperative complications. However, there were 4 postoperative complications, including 1 acute myocardial infarction and 3 periprosthetic joint infections. Overall, patients acquired improvements in ROM from 81.7 ± 23.1° to 96.8 ± 20.5° (p < 0.05), in KSS knee score from 64.2 ± 9.6 to 78.7 ± 12.1 (p < 0.05) and in KSS function score from 61.1 ± 7.4 to 77.3 ± 12.2 (p < 0.05) postoperatively. Patients in all 3 groups had improvements in ROM (p < 0.05), KSS knee score (p < 0.05) and KSS function score (p < 0.05). The overall recurrence rate was 22.9% (95% confidence interval (CI) 15.1–34.9%), and the overall revision rate was 14.9% (95% CI 8.6–25.6%). There were significant differences in both the symptom recurrence and prosthesis revision rates among the groups (p < 0.05). The PI group had a significantly lower symptom recurrence rate (11.4%, 95% CI 4.5–28.7%) and revision rate (8.6%, 95% CI 2.9–25.3%) (p < 0.017), while the GS group had a significantly higher recurrence rate (42.9%, 95% CI 23.4–78.5%) and revision rate (35.7%, 95% CI 17.6–72.1%) (p < 0.017). Conclusions In the setting of symptomatic TKA, although carrying certain risks for PJI and other complications, arthroscopic intervention could be feasible and provide clinical improvement in most cases at an average of 81.3 months follow-up. Patients with PI had the best outcomes, while patients with GS had the worst outcomes. Level of evidence Level IV